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Diseases of the nasal septum Epistaxis Turbinate hypertrophy

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Presentation on theme: "Diseases of the nasal septum Epistaxis Turbinate hypertrophy"— Presentation transcript:

1

2 Diseases of the nasal septum Epistaxis Turbinate hypertrophy
Nasal operations SAMI ALHARETHY ASSIS. PROF. CONSULTANT

3 Diseases of the nasal septum
Deviated nasal septum Septal hematoma and abscess Perforated septum

4 DEVIATED NASAL SEPTUM

5 Etiology Trauma Maldevelopment

6 Symptoms Nasal obstruction

7 Symptoms Nasal obstruction External deformity Crusting, epistaxis

8 Examination

9 Radiology Unnecessary in most cases

10 Treatment No treatment Septoplasty

11 Septoplasty

12 Complications of Septoplasty
Septal hematoma & abscess Septal perforation Nasal deformity Synechia (adhesion)

13 HEMATOMA OF THE SEPTUM

14 Etiology Direct trauma Operative trauma Blood dyscrasias

15 Clinical Features

16 Complications Cartilage necrosis Septal abscess
Permanent thickening of the septum

17 Treatment Incision and drainage Systemic antibiotics

18 PERFORATION OF SEPTUM

19 Clinical features Asymptomatic Crusting Epistaxis Whistling

20 Treatment No treatment Nasal wash Surgical closure

21 Surgical Reduction of the Inferior Turbinates
Turbinate resection, total or partial Outfracturing of the inferior turbinate Destructive procedures, including electrocautery, cryosurgery, laser surgery, and submucous resection

22

23 EPISTAXIS

24 Why bleeding from the nose ?
Vascular organ secondary to incredible heating/humidification requirements Vasculature runs just under mucosa Arterial to venous anastamoses ICA and ECA blood flow

25 SITES Anterior ( Little’s area)
Posterior (vicinity of sphenopalatine foramen)

26 Kesselbach’s Plexus/Little’s Area:
Anterior Ethmoid (Opth) Superior Labial A (Facial) Sphenopalatine A (IMAX) Greater Palatine (IMAX) Woodruff’s Plexus: -Sphenopalatine A (IMAX)

27 LOCAL CAUSES Acute trauma Chronic trauma Deviated septum
Inflammation of the nose and sinuses Tumors Idiopathic

28 SYSTEMIC CAUSES Coagulation and bleeding diseases Atherosclerosis
Familial hemorrhagic telangiectasia

29 MANAGEMENT General measures Stop the bleeding Prevent further bleeding

30 CONTROL THE BLEEDING Digital pressure Cautery Anterior nasal packing
Postnasal pack Arterial ligation Maxillary, Ethmoids, External carotid Arterial embolization

31 Anterior nasal packing

32 Postnasal packing

33 Arterial ligation

34 Arterial ligation

35 Arterial embolization

36 ANGIOFIBROMA Juvenile nasopharengeal Benign Adolcent Males
Frequent chronic epistaxis Nasal obstruction Rhinorrhea Conductive hearing loss Diplopia Otitis Media Treatment: embolization & Surgery

37 What do you think? 25 years old man post RTA with fever and nasal obstruction. What is your diagnosis? What is your management?

38 What is this radiological study? What is A,B and C?

39 This is a CT scan of a newborne who presented with respiratory
distress. A- what is your diagnosis? B- what is the management?

40 thanks


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